The better shape you're in before hip surgery, the greater chance of an easier recovery. Here are some ways to increase fitness prior to hip surgery.

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When Matt McGowan of Fayetteville, Ark., decided to have hip surgery, his goal was to be fully recovered and fairly free of hip pain by the time his wife gave birth to their third child. He had at least one thing working for him: his physical fitness level before hip surgery.

Hip Surgery and Fitness: Research Shows Better Recovery

Research is finding that your fitness level influences how long it takes to recover from hip surgery. In one recent study of 45 people who were scheduled for hip surgery, half were given exercises to do before the operation. The researchers found that those who exercised before hip surgery were able to use stairs, get in and out of a chair, and use the bathroom earlier than the other group. Just three days after hip surgery, the group that exercised had significantly more independence when changing their position in bed, standing, walking, moving from a sitting position to a standing position, and doing other basic activities. They also had more endurance when they walked.

In another study of 108 men and women who were scheduled for hip or knee replacement surgery, those who participated in a six-week exercise program before surgery had more muscle strength and better function after surgery than those who didn’t exercise.

Hip Surgery and Fitness: One Patient’s Story

McGowan had been having trouble with his hip since the age of 5, when he fell down bruised his hip, and then caught chicken pox. Because his hip had been injured, the virus spread to the joint and caused permanent damage. After having surgery as a child, he had a normal, pain-free childhood until his teenage years, when he developed osteoarthritis in his hip.

McGowan tried not to let hip pain slow him down during high school and played football and other sports until the pain was too much. By the time he was 17, he felt so stiff and sore after playing a football game that it took him hours to get out of bed the next morning.

Cutting out intense, pounding sports like running and football allowed him to manage the pain for years after high school. For exercise, he became an avid cyclist, riding almost daily. But when his first two children were born 18 months apart, the work of caring for them and carrying them around began to take its toll on his hip.

At the time, he was told that total hip replacement surgery would keep him in bed for three months, which wasn’t ideal with two small children at home. So he decided against it, and things got easier as his children became more independent. But when his wife told him she was pregnant with their third child, one of the first things he thought was, “I need to get that surgery.”

Intuitively, he knew that the better shape he was in before hip surgery, the easier and faster his recovery would be, so he continued to cycle every day in preparation. He believes his work paid off. He was on his feet the day after hip surgery and had three or four days of physical therapy in the hospital, followed by only one week of formal physical therapy at home. He was back to work after a month. “It felt like I could breathe again," McGowan says. "I was so grateful that I could carry my baby girl around without the pain.”

Hip Surgery and Fitness: How to Get Your Body Ready for Hip Surgery

Dave Pariser, PT, PhD, assistant professor of physical therapy at Bellarmine University in Louisville, Ky., who researches the effects of exercise and fitness before hip replacement surgery, found that patients do much better when they’ve prepared their body for surgery. “We call it pre-rehabilitation,” Pariser says. “If they’re stronger going in, they’ll do better after surgery.” They’ll need less medication for hip pain and may get back on their feet more quickly.

The key is to strengthen the muscles around your hip, which will help support your joint after surgery and lessen hip pain. Here are some tips for getting started.

Find a preconditioning program.

Pariser’s physical therapy clinic offers programs specifically designed to prepare patients for surgery; look for a similar program in your area.

Start as soon as you know you need surgery.

In a perfect world, three or four weeks of physical therapy or a preconditioning program are ideal, Pariser says.

Go for low-impact exercises.

For people with hip pain, the best way to become more fit is to do activities that have little impact on the joint, says Amy Humphrey, DPT, a physical therapist in Arlington, Va., and spokesperson for the American Physical Therapy Association. Swimming and water aerobics are excellent choices, Humphrey says, as are cycling and walking. Aim to exercise for 30 minutes a day most days of the week, but be sure to avoid high-impact activities such as running or basketball.

Stretch and strengthen.

A great way to increase your fitness level and strengthen your hip is by doing the bridge exercise every day, says Humphrey. Start by lying flat on your back and then bend your knees and put your feet hip-width apart on the floor. Lift your buttocks while tightening your stomach and hold for up to five seconds before coming back down to the floor. Be careful to create a straight line from your knees to your shoulders without arching your back. Gradually do up to three sets of 10 lifts each.

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